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Full Circle

As the Social Work Associate at Family Health Services of Drexel University, a Federally Qualified Health Center (FQHC) in North Philadelphia, I assist our uninsured patients in navigating the convoluted Welfare System to apply for Medical Assistance (Medicaid). In order to be found eligible for Medical Assistance, a person must be found at or below 100% of the Federal Poverty Level Guideline AND must have medical documentation confirming their disability. Disability? You mean you have to be disabled to qualify for Federal Health Insurance? With the exception of special populations, i.e. pregnant women and children, the only way to get health insurance is through a documented disability. For many of our patients, being “disabled” means suffering from the chronic disease trifecta: Diabetes, Hypertension, and Hyperlipidemia. Without follow-up care and health-sustaining medications, these diseases can have serious and fatal effects. For other patients, the disability is much more serious, like Multiple Sclerosis, Lupus, or Bipolar Disorder.

It’s rewarding to see your dedication and efforts to serve others come to fruition, to come full circle, for the benefit of the population you are serving. I recently had a conversation with someone on a personal level who mentioned that their neighbor was in desperate need of medical care, but had nowhere to turn because she was uninsured. During that personal conversation, I said, “That’s exactly what I do! Give your neighbors my card.” – Step One.

Several days later I received a phone call from a woman who mentioned our mutual contact and was inquiring about health insurance. Through our phone conversation I learned that this patient was living with constant, severe abdominal pain, the cause unknown. She had not seen a doctor in years, and had been in and out of the Emergency Room with little relief other than a prescription for ibuprofen, too often the fate for the uninsured population of the United States. With both she and her husband out of work, there was little hope in sight for resolving her health issues, let alone living a healthy life. I advised her that to apply for Medical Assistance through DPW it’s necessary to submit medical documentation completed by a primary care provider confirming a patient’s health risks. “You can come here,” I said. “We always see uninsured patients, and assess the copay using a sliding scale based on income.” I proceeded to explain the process for open-access, same-day appointments, the location of the health center, and the next steps in the insurance process. – Step Two.

Two weeks later, the patient called to let me know she had an appointment for that afternoon. I advised her of all the necessary documentation that DPW required for a Medical Assistance application (birth certificate, social security card, photo ID, proof of income, and medical documentation stating the necessity for insurance) and we met before her appointment that same afternoon. I advised her that we could start the application once her primary care provider signed off on the medical documentation. Following her appointment, her provider wanted her to follow-up with a gastroenterologist as soon as possible. I had everything I needed to complete the application with the patient and submitted it to DPW. – Step Three.

Two weeks later I checked on the status of the patient’s application and found that her insurance was active. She was now able to get the follow-up care she so desperately needed, but could have never afforded without Medical Assistance. – Step Four.

Four steps to a full circle: A person who fell through the cracks of the United States healthcare system found a medical home and a primary care provider, navigated the Welfare System through advocate assistance, and is now accessing medical care to improve her health and well-being. This is a success story, a minority of the applications for Medical Assistance I deal with, but it gives me strength and hope to traverse the difficulties advocating for all the others. It’s the reason we serve.